tag:blogger.com,1999:blog-9548566296243323912024-02-08T07:22:38.201-08:00Individual Health Plan SherpaIndividual Insurance Sherpa blog dedicated to bringing together the best information for consumers about purchasing individual health plans and provide them with resources for getting affordable health insurance quotes.Unknownnoreply@blogger.comBlogger5125tag:blogger.com,1999:blog-954856629624332391.post-44797031211169222272012-12-17T07:27:00.002-08:002012-12-17T07:30:20.552-08:00besthealthplans2013.com<h2>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-954856629624332391.post-30386368613931339932008-12-09T16:10:00.001-08:002008-12-09T16:10:58.691-08:00Health Insurance Can Be Funny<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/PkGUU_ggO3k&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/PkGUU_ggO3k&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object>Unknownnoreply@blogger.comtag:blogger.com,1999:blog-954856629624332391.post-73011346729422513372008-12-09T08:57:00.000-08:002008-12-09T09:00:35.479-08:00Health Insurance 101: Part 1Here are some basic terms from Wikipedia:<br /><br /><strong>Premium:</strong> The amount the policy-holder pays to the health plan each month to purchase health coverage.<br /><br /><strong>Deductible:</strong> The amount that the policy-holder must pay out-of-pocket before the health plan pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health plan. It may take several doctor's visits or prescription refills before the policy-holder reaches the deductible and the health plan starts to pay for care.<br /><br /><strong>Copayment:</strong> The amount that the policy-holder must pay out of pocket before the health plan pays for a particular visit or service. For example, a policy-holder might pay a $45 copayment for a doctor's visit, or to obtain a prescription. A copayment must be paid each time a particular service is obtained.<br /><br /><strong>Coinsurance:</strong> Instead of paying a fixed amount up front (a copayment), the policy-holder must pay a percentage of the total cost. For example, the member might have to pay 20% of the cost of a surgery, while the health plan pays the other 80%. Because there is no upper limit on coinsurance, the policy-holder can end up owing very little, or a significant amount, depending on the actual costs of the services they obtain.<br /><br /><strong>Exclusions:</strong> Not all services are covered. The policy-holder is generally expected to pay the full cost of non-covered services out of their own pocket.<br />Coverage limits: Some health plans only pay for health care up to a certain dollar amount. The policy-holder may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some plans have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.<br /><br /><strong>Out-of-pocket maximums:</strong> Similar to coverage limits, except that in this case, the member's payment obligation ends when they reach the out-of-pocket maximum, and the health plan pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.<br /><br /><strong></strong><strong>Capitation:</strong> An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.<br /><br /><strong>In-Network Provider:</strong> A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or copayments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-954856629624332391.post-91249722413411010672008-12-09T08:25:00.000-08:002008-12-09T08:39:42.139-08:00A Guide To Individual Health Insurance<strong>Top 5 Individual Health Insurance Questions</strong><br /><br /><strong>1. Why do you need health insurance?</strong><br /><br />As medical care advances and treatments increase, health care costs<br />also increase. The purpose of health insurance is to help you pay for<br />care. It protects you and your family financially in the event of an<br />unexpected serious illness or injury that could be very expensive. In<br />addition, you are more likely to get routine and preventive care if<br />you have health insurance.<br />You need health insurance because you cannot predict what your<br />medical bills will be. In some years, your costs may be low. In other<br />years, you may have very high medical expenses. If you have health<br />insurance, you will have peace of mind in knowing that you are<br />protected from most of these costs. You should not wait until you<br />or a family member becomes seriously ill to try to purchase health<br />insurance.<br />We also know that there is a link between having health insurance<br />and getting better health care. Research shows that people with<br />health insurance are more likely to have a regular doctor and to get<br />care when they need it.<br /><br /><strong>2. How do you get health insurance?</strong><br /><br />Most people get health insurance through their employers or<br />organizations to which they belong. This is called group insurance.<br />Some people do not have access to group insurance. They may<br />choose to purchase their own individual health insurance directly<br />from an insurance company. Many Americans get health insurance<br />through government programs that operate at the national, State,<br />and local levels. Examples include Medicare, Medicaid, and<br />programs run by the Department of Veterans Affairs and<br />Department of Defense.<br /><br /><strong>3. What is individual health insurance?</strong><br /><br />If you are self-employed or your employer does not offer health<br />insurance, you may not have access to group insurance. You may,<br />however, be able to purchase individual coverage directly from an<br />insurance company. When you buy your own health insurance, you<br />will be responsible for paying the entire premium rather than<br />sharing the cost with an employer. You should shop around to find<br />a plan that fits your needs at a price that you are willing to pay.<br /><br />Most self-employed workers are able to deduct their health<br />insurance premiums from their Federal taxable income, providing<br />them with an important tax saving. Most States also offer similar<br />tax preferences. If you are self-employed and buy individual health<br />insurance, you should consult a tax advisor to find out if you are<br />eligible for this deduction.<br />Insurance plans differ greatly from one company to another and,<br />within an insurance company, from one plan or product to another.<br />Some plans have multiple products (options) from which you can<br />choose; read carefully through the “fine print” to be sure you<br />understand the various choices.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-954856629624332391.post-62813645463176222932008-12-09T08:12:00.001-08:002008-12-09T08:13:51.157-08:00Welcome informed consumer.....My hopes from this blog is to showcase the best individual health plans and how to choose a plan wisely. At then end of the day, the key is to inform the consumer and ultimately drive the costs of health insurance down while driving quality up.Unknownnoreply@blogger.com